Monday, April 8, 2013

Health Tip: The Worst Ways to Treat Depression

Too often, we take the edge off emotional pain with a quick fix, instead of getting to the root of the problem. Here are nine depression "treatments" that can just make things worse
By Madeline Vann, MPH
Medically reviewed by Lindsey Marcellin, MD, MPH

Have you ever tried to eat, sleep, or drink your blues away?

Booze, comfort food, and all-day snooze-fests can temporarily numb feelings of depression — and because of that, self-medicating with these methods (instead of actually getting to the source of your depression and seeking treatment) may sound like a viable quick fix.

Actually, numbing your blue mood with unhealthy coping mechanisms may be one of the first signs of depression, explains Stephanie A. Gamble, PhD, assistant professor in the department of psychiatry at the University of Rochester Medical Center in New York. Gamble’s current research into depression in alcohol-dependent women reveals that many women aren’t fully aware of the link between their depression symptoms and their alcohol use until they take a lifetime look at their alcohol usage — when they started, and what they were using alcohol in reaction to.

By some estimates, nearly one in three people with depression have a substance abuse disorder, such as drugs or alcohol. But turning to these vices won’t actually get you the depression relief you seek — instead, it can just make things worse. On top of feeling depressed, you may find yourself in the midst of financial hardship, family conflict, and worsened mood.

“If you have someone who is depressed and using illicit drugs, or if you have someone who has a substance dependence problem and depression is layered in on that, it makes treatment more difficult,” Gamble says. “It’s going to make it more difficult to achieve remission.”

Depression ‘Treatments’ That Bring Self-Harm
Gamble explains that using unhealthy coping mechanisms often starts out fairly innocently, with people repeating something that brought them pleasure and relief in the past. But since these approaches can’t actually treat depression, the depression symptoms persevere, sometimes worsened by the efforts to self-medicate.

Some of the harmful ways people try to cope with depression include:

Booze. You will find alcohol in most social settings, and it’s even occasionally recommended (in small quantities) for good health. So it’s easy to slip into boozing regularly to ease emotional pain. “Oftentimes, the people around them become more aware of the problem than the people themselves,” says Gamble. If you have a personal or family history of alcohol abuse or find yourself going back to the bottle throughout the day, you could be at risk for dependence.

Drug use. Not only are most illegal drugs addictive, they can also interfere with the effectiveness of true depression treatment. “After the effects of the substance have worn off, you’re still left with that underlying sadness, irritability, or lack of interest or pleasure,” Gamble says. Just like alcohol, drug use may be followed by withdrawal. This, plus the guilt, shame, and fallout from the addiction can all perpetuate depression symptoms.

Painkillers. “The use of prescription painkillers is on the rise, and emergency departments are seeing increases in overdoses and certainly an increase in dependence,” Gamble says. Painkiller addiction often begins with a legitimate need for pain relief, but if you’re using painkillers to numb not just physical pain but also emotional pain, that’s a problem.

Comfort food. You wouldn’t be the first to reach for a doughnut on a rough day, but if it’s a regular habit, you might be overeating in an effort to cope with depression. Medical researchers are beginning to look at whether being overweight increases the risk for depression for physiological reasons — so be aware that you could literally be feeding your depression with this approach.

Shopping. It’s called “retail therapy” for a reason: Shopping provides some people with temporary depression relief. Apart from not addressing important issues, Gamble points out that, if you don’t have the resources to pay the credit card bill at the end of the month, getting yourself into debt could just make things worse.

Promiscuity. Studies have shown a link between risky sex (unprotected sex or sex with new partners) and depression. Like shopping, this can provide short-term relief, but the long-term impact on physical and emotional health might just make depression worse.

Self-mutilation. This type of self-harm involves causing yourself physical pain — such as picking at or cutting your skin, or even biting yourself — to ease emotional pain. By some estimates, as many as 1 percent of people have engaged in some kind of self-harm.

Sleeping the day away. Depression can cause severe and sudden changes in sleeping habits. If the thought of staying in bed today (and tomorrow, and the day after that) sounds better than having to get up and deal with your life, this could be a warning sign that you are depressed. Sleeping, as much as it might seem like a refuge from your problems, is not so much a depression treatment as a symptom.

Suicidal thoughts. Planning your own death, called suicide ideation, might seem like the best way out of the dark world of depression. However, having these thoughts is a severe symptom of depression — and depression can be treated. Urgent treatment is needed in this case to steer you away from this permanent solution to a temporary and treatable problem.

Depression Treatments That Do Work

Though treating depression should be individualized, the most effective depression relief is likely to come from a combination of the following:

Talk therapy. Many people can achieve significant relief through cognitive behavioral therapy or another therapeutic approach with a mental health professional that helps them identify what is (and isn’t) working well in their lives.

Medication. Depression relief for specific or severe symptoms usually can be obtained through the right antidepressants.

Addiction treatment. Because substance abuse and addictive behaviors (shopping, sex, or gambling) can actually make depression worse or treatment-resistant, you should get help with these issues as well. Twelve-step programs are very effective.

Usually, combining medication and therapy with appropriate lifestyle changes will bring about the best results.